With Medicaid set to expand across North Carolina, Wake County leaders are wasting no time preparing to serve approximately 60,000 residents and their families who could soon be eligible for health coverage for the first time.

Pending passage of the state budget, Wake County could see the largest wave of Medicaid applications of any county in the state. Wake County Health and Human Services staff process the applications, but at current staff levels, they would not be able to support the expected surge of applicants. That’s why Wake County Commissioners unanimously approved funding on Monday for 74 additional full-time Medicaid positions.

“The bi-partisan passage of Medicaid expansion was groundbreaking and means thousands of working adults, their families, veterans and those struggling with mental health issues will have access to the health benefits they deserve,” said Shinica Thomas, chair of the Wake County Board of Commissioners. “As the most populated county in the state, we need to be able to meet that demand, and these new positions will ensure we’re doing all we can to reduce the red tape and approval wait times.”

Medicaid is a federal health insurance program administered in part by the state but processed at the local level by counties. The expansion bill passed in March opened coverage to adults who previously made too much money to qualify, but not enough to qualify for federal subsidies to buy health insurance on their own. Legislators agreed to help those families who fell into this “coverage gap” by increasing Medicaid eligibility to those who make up to 138% of the federal poverty level, which would be about $41,000 for a family of four.

Wake County’s Economic Services Medicaid Team would work with these new applicants to determine their eligibility. Right now, the team has 112 full-time staff members and only three vacancies. Currently, they process anywhere between 4,300 and 7,800 applications every month. 

Staff estimate that more than 100,000 applications might be submitted under the new expanded program in Wake County alone. Historically, however, as many as 50% may be deemed ineligible. Regardless, every application is reviewed and takes the same time to process. Anyone who believes they could be eligible are strongly encouraged to apply, as there is no application fee and it could mean thousands of dollars in health benefits. Wake County estimates that, over a two-year period, Medicaid’s expansion will add approximately 4,167 more applications per month, on top of applications already being processed each month.  

In addition to new applicants, there are already over 200,000 residents enrolled in Medicaid, and Wake County staff must review their applications annually. The newly approved staff positions will help ensure that each beneficiary, whether existing or new, is served in a timely manner.

The new positions funded today include:

• 60 case workers
• Six supervisors
• Eight support staff

The average wage for these new positions will range between $19 – $31 an hour. Most of the positions will work a hybrid schedule after completing required in-person training.

It’s anticipated the cost of the position would be about $5 million with funding coming from N.C. Department of Health and Human Services’ reimbursable revenues at $3.3 million with a County match of $1.3 million, as well as a one-time lump sum from NCDHHS of $436,122 designated to assist with Medicaid expansion.

Hiring is expected to begin later this summer, and all information about the positions will be posted on wake.gov/careers.

The board’s actions today support its community health and vitality goal of supporting a higher quality of life for vulnerable residents and communities.